Services

Pediatric Services are divided into three broad categories:

(1) Preventive, or well child, care.

The cornerstone of preventive care is the immunization. At this time vaccines are available for many childhood diseases that formerly threatened the life and health of millions of children in America, and are still a hazard in many parts of the world; many others are in the "pipeline", meaning that someone, somewhere, is testing them to deteremine if they are safe and effective. We generally do not participate in efficacy trials, as we prefer to offer only tried and tested interventions to our patients.

Well care also includes monitoring of growth, development, and routine blood tests, for early diagnosis of disorders that respond to early treatment and intervention.

(2) Care of sick children.

In this we may or may not be the only doctors your child will need, but we will most likely be the first to see him or her. Because of immaturity of the infant immune system, many infections progress more rapidly, and with fewer identifiable signs or symptoms, than in adults; on the other hand, they may run very high fevers with relatively mild illnesses. In children, asthma can be indistinguishable from an acute infection, foreign bodies may go unnoticed for months or years and be undetectable by Xray, and allergic and infectious rashes can look very much alike.

It is our emphasis on timely diagnosis that necessitates reliance on high technology. The CBC machine, giving us the white count and three-part differential in under a minute, allows us a glimpse into the immune system's own evaluation of the ongoing disease process; the red cell count and indeces allow for early diagnosis of iron and vitamin deficiencies, not to mention information needed for school and WIC forms; rapid strep test allows immediate treatment of a common infection known for common complications; pulse oximetry, ECG, spirometry are available to assess heart and lung function, and tympanometry and OAE analyzer allow for better assessment of the child with suspected, or past, ear infection than is possible by visual examination alone.

(3) Consulting.

Pre- and post-adoption services for children adopted from the former Soviet republics: This includes review of charts, reports, videos and other records of prospective and current adoptees, as well as in-person meetings, to assist in better preparation for integration of adoptees into the family and society.

Forensic pediatrics, especially assistance in custody hearings.

Some of the equipment we use to aid in early diagnosis:

This is an Abbott Celldyne 1800 CBC analyzer. It helped us save a child, and the livelihood of a day care center, by diagnosing a blood disease in a little girl who came home from day care with a huge bruise that appeared to be a result of child abuse. It helped us save several children with bleeding ulcers, pneumonia, appendicitis by showing ominous changes in blood counts long before anything can be detected on physical exam.

This is a Welch-Allyn tympanometer. It shows changes in the middle ear that can lead to ear infection -- long before anything is visible through an otoscope.

This is a strep test kit. Would you believe strep throat can look like a stomach virus? This lets us start treatment long before the throat can turn beefy red with petechiae and pus on tonsils.

This is a Nellcor pulse oximeter. It can pick up some of the heart defects that do not generate a heart murmur, or pick up that one child in whom a severe respiratory illness is masquerading as a mild bronchitis.

This is a nebulizer. It helps us break an asthma attack in the office -- so you can go home, not to the emergency room.

This is a Welch-Allyn hearing screener. If your toddler is ignoring you, is it Terrible Twos or a hearing impairment? We'll know in five minutes.

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